%PDF-1.4
%
140 0 obj
<>/Metadata 137 0 R/OpenAction 141 0 R/Outlines 208 0 R/PageLayout/SinglePage/PageMode/UseOutlines/Pages 136 0 R/StructTreeRoot 33 0 R/Type/Catalog/ViewerPreferences<>>>
endobj
142 0 obj
<>/Font<>>>/Fields[123 0 R 121 0 R 119 0 R 117 0 R 115 0 R 105 0 R 104 0 R 82 0 R 78 0 R 76 0 R 72 0 R 70 0 R 68 0 R 66 0 R 64 0 R 113 0 R 110 0 R 107 0 R 60 0 R]/SigFlags 1>>
endobj
137 0 obj
<>stream
application/pdf
University of Missouri System
CERTIFICATION OF HEALTH CARE PROVIDER – SHARED LEAVE PROGRAM FOR EMPLOYEE’S SERIOUS HEALTH CONDITION
Employee (self) Healthy Provider form for the Shared Leave Program
shared
leave
program
employee
self
health
provider
form
university
missouri
system
human
resources
program
2019-10-15T10:22:36-05:00
Microsoft® Word 2016
2026-03-11T12:56:41+05:30
2026-03-11T12:56:41+05:30
Microsoft® Word 2016
shared, leave, program, employee, self, health, provider, form, university, missouri, system, human, resources, program,
uuid:23a2d06b-18ad-4600-997f-127a68964e63
uuid:c0cfaedc-f9ef-4f4e-a8c1-0bf0be854180
1
1.1
1
endstream
endobj
141 0 obj
<>
endobj
208 0 obj
<>
endobj
136 0 obj
<>
endobj
33 0 obj
<>
endobj
34 0 obj
<>
endobj
35 0 obj
<>
endobj
36 0 obj
[null 124 0 R 125 0 R null 126 0 R 127 0 R 69 0 R 67 0 R 65 0 R 63 0 R 128 0 R 129 0 R 122 0 R 120 0 R 118 0 R 116 0 R 130 0 R 131 0 R 132 0 R 96 0 R null null 97 0 R 91 0 R null null 92 0 R 101 0 R null 86 0 R 98 0 R 99 0 R 93 0 R 94 0 R 102 0 R 103 0 R null 100 0 R 95 0 R null 85 0 R 133 0 R 81 0 R 77 0 R null null 134 0 R null null 75 0 R 59 0 R null 71 0 R null 135 0 R]
endobj
37 0 obj
<>/P 122 0 R/S/Form/T()>>
endobj
38 0 obj
<>/P 120 0 R/S/Form/T()>>
endobj
39 0 obj
<>/P 118 0 R/S/Form/T()>>
endobj
40 0 obj
<>/P 116 0 R/S/Form/T()>>
endobj
41 0 obj
<>/P 100 0 R/S/Form/T()>>
endobj
42 0 obj
<>/P 98 0 R/S/Form/T()>>
endobj
43 0 obj
<>/P 93 0 R/S/Form/T()>>
endobj
44 0 obj
<>/P 102 0 R/S/Form/T()>>
endobj
45 0 obj
<>/P 99 0 R/S/Form/T()>>
endobj
46 0 obj
<>/P 94 0 R/S/Form/T()>>
endobj
47 0 obj
<>/P 103 0 R/S/Form/T()>>
endobj
48 0 obj
<>/P 95 0 R/S/Form/T()>>
endobj
49 0 obj
<>/P 85 0 R/S/Form/T()>>
endobj
50 0 obj
<>/P 81 0 R/S/Form/T()>>
endobj
51 0 obj
<>/P 77 0 R/S/Form/T()>>
endobj
52 0 obj
<>/P 75 0 R/S/Form/T()>>
endobj
53 0 obj
<>/P 71 0 R/S/Form/T()>>
endobj
54 0 obj
<>/P 69 0 R/S/Form/T()>>
endobj
55 0 obj
<>/P 67 0 R/S/Form/T()>>
endobj
56 0 obj
<>/P 65 0 R/S/Form/T()>>
endobj
57 0 obj
<>/P 63 0 R/S/Form/T()>>
endobj
58 0 obj
<>/P 59 0 R/S/Form/T()>>
endobj
59 0 obj
<>
endobj
143 0 obj
<>/MediaBox[0 0 612 792]/Parent 136 0 R/Resources<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>>
endobj
144 0 obj
[70 0 R 66 0 R 68 0 R 64 0 R 123 0 R 121 0 R 119 0 R 117 0 R 114 0 R 112 0 R 115 0 R 111 0 R 109 0 R 105 0 R 108 0 R 106 0 R 104 0 R 82 0 R 78 0 R 76 0 R 60 0 R 72 0 R]
endobj
220 0 obj
<>stream
HWn$Wԑ-gA4nvchg[0#Xr%HVE?~;>/;թ.ht_uw{2W_|bs;=\;_wdnN~38EQllЊipcZbߥa=~o8 ^f
YR3:˗^{mZt&ԁh\q3ЎvB;o@鳣֮Ød #AnqJzOokanlSȗ% 9{W2̪^1|